| NPI | 1609581271 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305215537) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 25771) |
| Enumeration Date | 2023-01-18 |
| Last Update Date | 2023-12-12 |